Finding into death of MD

82y · Male·Complications of large bowel obstruction in a man with diverticular disease and other co-morbidities

An 82-year-old man died from complications of large bowel obstruction secondary to a sigmoid mass while incarcerated at Port Phillip Prison. He presented with abdominal pain and vomiting following a fall, and imaging confirmed large bowel obstruction. A colorectal fellow recommended emergency surgery (laparotomy and Hartmann's procedure), but perioperative medicine and ICU teams deemed him too high-risk due to extensive comorbidities including heart failure, chronic kidney disease, atrial fibrillation, and peripheral vascular disease. Following discussion with the patient and family, palliative management was chosen. The coroner found the medical care was reasonable and the death was not preventable, noting that early detection of the bowel mass would unlikely have changed outcomes given his comorbidities precluded most treatments.